Scoliosis secondary to neglected Hemivertebra: A case report.

INTRODUCTION AND IMPORTANCE: A hemivertebra is a congenital anomaly of the spine characterized by an incomplete vertebra resulting from a failure in the formation of the vertebral body. The significance of this article lies in the fact that early diagnosis of hemivertebra allows for personalized surgical treatment, which can enhance outcomes and prevent the development of spinal deformities and associated complications. CASE PRESENTATION: We report on the case of a 17-year-old girl with scoliosis secondary to lumbar hemivertebra, where surgical management was very late due to parental negligence, which delayed diagnosis. DISCUSSION: Multiple surgical procedures are currently used for hemivertebra excision. The approaches available can be globally anteroposterior or posterior alone. Late treatment of this type of deformity requires longer fusion, with a high risk of neurological complications. Early surgical intervention is therefore indicated to correct local deformities. Early correction of primary deformities helps avoid secondary changes. CONCLUSION: Hemivertebrae represent an interesting group of congenital anomalies. Their presence can potentially disrupt the normal curvature of the spine. Antenatal ultrasound screening enables early diagnosis of congenital malformations. Early diagnosis of a hemivertebra allows early surgical management that is less aggressive than when the diagnosis is made late, during growth.

En bloc vertebrectomy: A radical technique for spinal metastases but rarely used.

INTRODUCTION AND IMPORTANCE: Total vertebrectomy En bloc by posterior approach is proposed for primary or secondary single-site malignant tumors of the spine to reduce local recurrence and increase patient survival. This type of surgery is gaining increasing recognition. However, it requires a high level of technical skill and knowledge of the anatomy, physiology and biomechanics of the spine. CASE PRESENTATION: We present here a case of a patient with a single thoracic metastasis with neurological deficit treated by total vertebrectomy via the posterior approach, using a cage and pedicle screws in situ. DISCUSSION: This surgery is technically demanding, and patient selection therefore requires careful preoperative evaluation. CONCLUSION: The reproducibility of the En bloc vertebrectomy method documented in the literature is demonstrated and supported by our case.

Bilateral symmetrical extradural hematoma in an older person: A case report.

INTRODUCTION AND IMPORTANCE: The occurrence of bilateral extradural hematomas (EDH) is a rare consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare even more so in elderly subjects. PRESENTATION OF THE CASE: We report the case of an 82-year-old patient who had fallen down a flight of stairs. Scalp examination was consistent with a bi-parietal subgaleal hematoma. Clinically, he was confused with a glascow score of 13/15. His brain scan showed bilateral and symmetrical parietal EDH with simple fractures of both parietal bones. The patient underwent a two-stage evacuation of the extra-dural hematomas. CLINICAL DISCUSSION: The management of bilateral EDH cases requires careful planning, adequate exposure, judicious surgical approach and time management for good results. CONCLUSION: To our knowledge, no case of bilateral hematoma in an elderly subject has been reported in the literature.

[Osteoblastoma of the parietal bone of the cranial vault: about a case]. / Ostéoblastome de l'os pariétal de la voûte du crâne: à propos d'un cas.

Osteoblastoma is an uncommon primary bone tumor. Its occurrence in the cranial vault is extremely rare. We here report our first case of right parietal bone osteoblastoma in a 46-year old woman with a history of benign cranial traumas. She reported progressive painful, non-inflammatory right parietal bone swelling. Craniocerebral CT scan showed hyperdense bone lesion with sparing of the internal table of the right parietal bone. The patient first underwent biopsy, then complete resection of the bone lesion with methyl-methacrylic cement cranioplasty. The postoperative course was uneventful. Anatomopathological examination showed osteoblastoma with no sign of malignancy. This study and literature review highlight the clinical manifestation, the radiological and anatomopathological features as well as the management of osteoblastoma of the parietal bone of the cranial vault.

Epidural cavernous haemangioma during pregnancy: a case report and a literature review.

Cavernous haemangiomas are benign vascular malformations that can locate in the central nervous system. The epidural spinal location remains unusual. Pregnancy is known to be a precipitating factor. The aim of this study is to review general aspects of these lesions and specific facts about their relationship to pregnancy. A 32-year-old full-term pregnant woman is managed during early labor for a progressive spinal cord compression syndrome. After delivery, exploration by a lumbar MRI found an epidural vascular dorsal mass. Surgical exploration and histopathological examination confirmed the diagnosis of epidural cavernous haemangioma. The patient achieved complete recovery after 1 month. Spinal cavernous haemangiomas are rare malformations. Specific mechanisms seems to be involved in their growth during pregnancy. Although clinical and radiological presentation are spectacular and misleading, the prognosis is generally good, and urgent surgical treatment during pregnancy is usually not indicated.

[Astroblastoma: A rare glial tumor]. / L'astroblastome : une tumeur gliale rare.

Astroblastoma is a rare neuroepithelial tumor most commonly seen in children and young adults. Due to its rarity, this tumor can be easily misdiagnosed as its classification, histogenesis and therapeutic management are still being discussed. We report the case of a 21 year old man, who presented at the Emergency Room for loss of consciousness. He reported a history of headaches, vomiting and decreased visual acuity. The CT and MRI showed a left temporoparietal solid-cystic mass with heterogeneous enhancement and perilesional edema. The patient underwent a total mass resection. On histopathological examination, tumor cells were organized in perivascular pseudorosettes which are typically encountered in astroblastoma, without neither necrosis nor endothelial hyperplasia. They had broad processes and rounded nuclei without any mitotic activity. Immunochemistry stains confirmed the diagnosis by showing a positive reactivity for GFAP, EMA, vimentin and S100. Astroblastoma is a rare glial tumor of uncertain origin. Clinical presentation and imaging are nonspecific. Therefore, its diagnosis is based on histopathologic findings: typical perivascular pseudorosettes. However, similar histological pattern may be seen in other glial neoplasms. In the 2016 WHO Classification, astroblastoma is among the "other glial neoplasms" without a grading system. So far, there are no reliable prognosis factors for this tumor; however, two entities have been described: well differenciated astroblastoma (considered as low grade) and anaplastic/malignant astroblastomas (considered as high grade). Gross total resection is the treatment of choice for astroblastomas. Adjuvant therapy is still controversial. This case illustrates a cerebral tumor which is rarely encountered in practice and that can cause diagnostic problems and subsequently, inadequate treatment.